Al Jolson Society - Application

Al Jolson Home Page|The IAJS|Application

The
International
Al Jolson
Society


If you would like to join the International Al Jolson Society, please complete the application below. Send your dues to the post office box on the first page, and it will all be forwarded to the Society treasurer. Please be sure to fill out all blanks, including your Email address, so that I can acknowledge your submission!

            Name: 
  Street address: 
                  
            City: 
  State/Province: 
        Country*:  *if not US
 Postal/ZIP Code: 
       Telephone: ( )  ext: North America only
                  ++-  ext: outside North America
   email address:  I need this to acknowledge your submission!
      occupation: 
       birthdate: 
Any comments?  How did you find this site?  

Thank you for your information, please press the JOIN button to send the information to the International Al Jolson Society.


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This listing and material Copyright © 2001 Marc I. Leavey, M.D. Baltimore, Maryland
Updated 21 May 01

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